Evaluation of Altmetric Analysis Scores of the Top 100 Articles on Polycystic Ovary Syndrome Published in the Last 10 Years

Objective: In the current study, we analyzed the 100 most cited articles with the topic, title, and keywords of polycystic ovary syndrome (PCOS) published in all journals in terms of traditional metrics and the altmetric score (AS). Methods: The term “polycystic ovary syndrome (PCOS)” was searched in the Web of Science (WoS) database and filtered for articles published in all journals. Bibliographic data and AS were obtained for 100 highly cited papers from January 2012 to July 2022. Descriptive statistics were reported and correlation analysis between traditional bibliographies and the AS was performed. Results: The Journal of Clinical Endocrinology & Metabolism, with 14 articles, had the most publications on the Top 100 list. When the studies were classified according to subtypes, 56 papers were original scientific papers with mean AS of 32.5 (15.3-52.7), whereas 44 papers were reviews and meta-analyses with AS of 16.0 (8.6-43.2). The AS was positively correlated with H-index, total WoS citation number of article and Q category. There were no correlations with impact factor (IF), five-year IF, journal impact factor (JIF) percentile and journal citation indicator (JCI) value. Conclusion: Our results suggest that the AS is related with article total WoS citation number, journal Q category, and journal H-index. Effective communication on social media can promote scientific productivity and have a positive impact on society.


Introduction
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women and patients are adversely affected due to metabolic, reproductive, and psychological impacts [1]. Obesity, metabolic syndrome, type 2 diabetes, and an increased risk of cardiovascular disease are well-known important complications of PCOS and remain the most common cause of anovulatory infertility today [2][3][4]. The diagnosis of PCOS is obtained after excluding other causes and by detecting two of the existing Rotterdam criteria (biochemical/clinical hyperandrogenism, oligo-amenorrhea, and polycystic ovaries on ultrasound) [5,6].
In the scientific world, the quality of research is determined by the number of citations and the impact factor of the journal. Today, the use of social media is growing rapidly, and this situation is becoming increasingly important for academic literature and scientific journals. Altmetrics is an alternative assessment of research driven by social media that includes the number of views, downloads, and reads of an article on social media and mainstream media and inclusion in public policy documents, in addition to the citation number, and measures the impact of the article online. Altmetrics was designed to monitor and quantify the impact of research based on social media mentions and collects dissemination data from social media channels such as Facebook, Twitter, Google+, etc. [7,8]. It is clear that the use of social media will increase in the future, and one-third of people in developed countries use social media today [9]. Thus, it is a natural progression of this widespread use of social media to include dissemination via social media and non-traditional sources in new citation analyses for reputable journals. Altmetric.com is one of the most popular websites that calculates altmetrics and offers them to researchers. All authors, including us, wonder how much impact our publications will have on social platforms. The altmetric system easily and practically provides authors with this information. As altmetrics increase in popularity, journals are beginning to provide altmetric scores in addition to citation scores for published research.       Table 3).

Study Type Number of Articles Altmetrics Scores Citations
All article  Correlation analysis results between the AS and IF, 5-year IF, H-index, total WoS citation number, Q category, JIF percentile and JCI value are illustrated in Table 5.

Discussion
As far as we know, this is the first study to analyze the 100 most cited articles on the topic, title, and keywords of polycystic ovary syndrome or PCOS published in all journals in terms of traditional metrics and altmetrics.
The number of citations an article receives after it is published shows the contribution of the article to science and the effectiveness of the article. However, even if the scientific article is making significant contributions to science, authors citing this article in their new studies, the peer-review process, acceptance, and publication of the article may cause years to pass before the previous article is cited [11,12]. In addition, citations of some important studies will be affected because journals allow a specific order of references and authors use this limited order of references. However, nowadays, thousands of scientific contents are shared on the internet and respected journals ensure that accepted articles are first recognized online so that the scientific content is cited more. For this situation, many journals offer open access publication options and want the scientific article to be online very quickly. Using a variety of sources, altmetrics report the engagement level with research posted online using the daily activity of researchers on the internet and social media [13]. Because both the public and academics use altmetrics, they can be subjected to negative interferences (such as spam). An evaluation of the Top 100 trending articles in neurosurgery journals found that the articles in journals with social media accounts have a higher AS than articles in journals without a social media account [14]. Consequently, some journals aggressively use social media to promote their articles while others do not, which can greatly impact the AS. In addition, popular topics may receive a lot of interaction, whereas more technical topics may receive less interaction.
Another important factor affecting the coverage of the articles on social media may be whether they address important diseases affecting society. For example, today, the widespread news value of headlines such as COVID-19, obesity, and hypertension causes them to be more effective on social media. Of course, this does not apply to PCOS. Few studies evaluate PCOS-related research with bibliometric analysis [15,16]. In addition to these studies, as far as we know, this is the first study to analyze the 100 most cited articles on the topic, title, and keywords of polycystic ovary syndrome or PCOS published in all journals in terms of bibliometrics and altmetrics. When reviewing the articles on the Top 100, the studies with the highest AS are research articles and reviews on the diagnosis of PCOS and its relationship with infertility. to the increased usage of social media over the years. Because recently published articles have not had time to be frequently cited, they were excluded from our list and evaluation. In addition, we found that although there are similar citations, original scientific papers have a higher AS than systemic reviews and metaanalyses, which was not expected. In the current study, we found that the AS was positively correlated with H-index (r: 0.536, p <0.05), total WoS citation number of article (r: 0.416, p <0.05) and Q category (r: 0.358, p <0.05). There were no correlations with IF (r: 0.187, p =0.064), 5 years IF (r: 0.168, p =0.097), JIF percentile (r: 0.168, p =0.096), and JCI value (r: 0.172, p =0.088). Similarly, a study of urology journals found a weak correlation between the AS and the number of citations [17]. In radiology, the AS and the number of citations also showed a weak correlation [18].
Our study had some strengths. The AS for the 100 most-cited articles in the PCOS field was examined for the first time. In our study, we examined all medical journals instead of only gynecologic journals, which enhance the effectiveness of the study results.In addition, we scanned not only the topics of the study but also scanned the title and keywords. In this way, we did not miss many important studies. Additionally, open access journals were included indiscriminately when scanning. This will of course have an impact on AS. The AS can reflect attention at the moment for an article but not necessarily its true worth over time. However, good communication on social media can boost scientific productivity and impact society. For journals, altmetrics can be an important tool for reaching their targeted audience and letting them know how much attention an article has received. The AS is useful as a supporting metric and its importance is expected to increase over time.

Conclusions
Our results suggest that the AS is related to article total WoS citation number, journal Q category and journal H-index but unlike traditional bibliometrics, it may be insufficient to determine an article's overall scientific importance. However, effective communication on social media can promote scientific productivity and have a positive impact on society.

Additional Information Disclosures
Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.

Conflicts of interest:
In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.